Steunebrink M, Schnater J M, Storm R K, van Ingen G, Vegt P A, Plaisier P W
Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300AK Dordrecht, The Netherlands.
Breast. 2005 Apr;14(2):165-8. doi: 10.1016/j.breast.2004.06.001.
The case of a 47-year-old premenopausal woman is presented in whom axillary lymph node metastases occurred on both sides 3 years apart although no primary tumor was detectable in either breast is presented. An overview of the literature on this rare entity is given. Patients with occult breast carcinoma with axillary lymph node metastases should have a complete physical examination, radiologic analysis (mammography, ultrasonography, and MRI of both breasts) and screening for disseminated disease. If there is no evidence of a primary tumor and metastases other than in the axilla, an axillary dissection should be carried out. In addition, the patient should be offered the choice of irradiation of the breast or mastectomy. Postoperatively, patients should receive appropriate systemic therapy tailored to their age, menopausal status, and receptor status.
本文报道了一例47岁绝经前女性的病例，该患者双侧腋窝淋巴结转移间隔3年出现，尽管双侧乳房均未检测到原发性肿瘤。本文还对关于这一罕见实体的文献进行了综述。隐匿性乳腺癌伴腋窝淋巴结转移的患者应进行全面的体格检查、放射学分析（双侧乳房的乳腺X线摄影、超声检查和MRI）以及播散性疾病筛查。如果除腋窝外没有原发性肿瘤和转移的证据，则应进行腋窝清扫术。此外，应让患者选择乳房放疗或乳房切除术。术后，患者应根据其年龄、绝经状态和受体状态接受适当的全身治疗。
